A few weeks ago, I discussed Utah’s attempts to call porn a public health crisis.  I don’t think such a designation is useful for a few reasons:  (1) the Utah Legislature allocated no funds to combat the problem, (2) there is considerable debate about whether porn or sex addiction is a legitimate scientific condition, and (3) there are many other health issues more important than porn. Furthermore,

The state of Utah has recently declared pornography a public health crisis.¹³They also recently voted down science-based school sex education.¹⁴ This shows that they’re more interested in condemning porn than in supporting the healthy sexuality of their young people. It also helps explain why Utah has the highest per capita use of porn in the country, and one of the highest rates of unwanted pregnancy.

Let me first state that I am sad that many feel they are addicted to sex.  Some high profile names include Tiger Woods, Michael Douglas, Charlie Sheen, and David Duchovny.  It’s almost always men who claim addiction.  It took me a while, but I did find two female “celebrities” whom I never heard of that claim sex addiction: Playboy model Nicole Narain, and beauty contestant Kari Ann Peniche.

Furthermore, I don’t want to minimize that some people experience problems with porn.  Dr. Jonathan Alpert writes

In this age of celebrities and politicians coming forward with their claims of sex addiction following a cheating incident, I’m often asked whether sex addiction even really exists. My answer is both yes and no. According to the medical community, more specifically, the Diagnostic and Statistical Manual of Mental Disorders (DSM), it doesn’t exist. That aside, and looking purely at patterns of behavior and what’s going on inside the person’s head, well, that’s a different story.

Although not formally recognized by the medical establishment, there are troubling behaviors that resemble a compulsion. If you’re the person who is consumed by sexual urges, activities, and fantasies, and your behavior is directed at achieving the goal of sex at all cost, then you have a problem. If this continues despite such adverse consequences as getting in trouble at work for looking at pornography, running up credit card debt for sex services, contracting an STD, and even getting caught, literally, by your significant other with your pants down, then you definitely have a serious problem.

Substance abuse, food addiction, sexual compulsion — whatever the demon —similar mechanisms are at play: One feels depressed or anxious, stressed, or seeks a high and reaches for the bottle, drugs, food, or sex. Feelings are numbed, a high or thrill is reached, and the perpetual reward process in the brain is triggered. This powerful reward system targets the area of the brain that releases dopamine, the “feel good” neurotransmitter and the behavior is reinforced. Throw into the mix the often larger-than-life sense of entitlement and narcissism that runs amok in the world of celebrities and there’s even more potential for cheating, compulsive behavior, and ultimately the label of “sex addict.” However, it should be noted, claims of “sex addiction” seem to be the diagnosis du jour as society and Hollywood are quick to label celebrities who cheat as “sex addicts.” This sometimes is more of an excuse to gain public sympathy than it is fact. Addiction or not, with dedication, expert help, and lots of hard work, one can improve and learn healthy ways to cope and to make better decisions.

There are a few problems (or benefits, depending on which side of the label you are on) with the labels of porn or sex addiction.  On the one hand, sex addicts claim that they are not responsible for their actions.  Essentially they are saying that the compulsion takes away their free-agency, their ability to choose between right and wrong.  Is that something a faithful Mormon or Christian can accept?  Steven Cave writes that some scientists believe that free will is an illusion, whether or not one has any addictions or compulsions.  Even the most moral people are incapable of free will or free agency.

The challenge posed by neuroscience is more radical: It describes the brain as a physical system like any other, and suggests that we no more will it to operate in a particular way than we will our heart to beat. The contemporary scientific image of human behavior is one of neurons firing, causing other neurons to fire, causing our thoughts and deeds, in an unbroken chain that stretches back to our birth and beyond. In principle, we are therefore completely predictable. If we could understand any individual’s brain architecture and chemistry well enough, we could, in theory, predict that individual’s response to any given stimulus with 100 percent accuracy.

This research and its implications are not new. What is new, though, is the spread of free-will skepticism beyond the laboratories and into the mainstream. The number of court cases, for example, that use evidence from neuroscience has more than doubled in the past decade—mostly in the context of defendants arguing that their brain made them do it.

If we accept the addiction model, I don’t think many of us are willing to suspend belief in free agency.  Even addicts have free agency, although their ability to make good choices may be compromised a great deal.

For me the question isn’t so much whether Utah has a problem with porn, but (1) where does Utah fit within that problem, and (2) what are the best solutions to solve the problem?  When looking at other forms of addiction and compulsion, the United States tried Prohibition of alcohol once, and it doesn’t work so well.  Prohibiting alcohol was so bad that Utah cast the deciding vote to repeal Prohibition.

Utah put the amendment over the top even though Heber J. Grant, then president of The Church of Jesus Christ of Latter-day Saints, had urged church members not to support repeal, noting for example that highway deaths had decreased greatly during Prohibition.

Despite the official stance of the church, many prominent Utahns argued that repeal was inevitable and a better alternative than the gangsterism, bootlegging, bathtub gin production, speak-easies and other illegal activities that mushroomed under the ban.

This is a perfect example of where the cure introduced other unintended consequences that Utahns decided that were worse than Prohibition itself.  While Utah’s designation that porn is a public health crisis is pretty toothless, trying to ban porn, or even making it more taboo may is not helping and may make the problem worse.

Speaking of addiction, Portugal had a huge drug problem, and has looked at the failed US experiment with Prohibition, and wanted to see what would happen if the country legalized all drugs.  Many in law enforcement were skeptical that this solution would help.

Nearly fifteen years ago, Portugal had one of the worst drug problems in Europe, with 1 percent of the population addicted to heroin. They had tried a drug war, and the problem just kept getting worse. So they decided to do something radically different. They resolved to decriminalize all drugs, and transfer all the money they used to spend on arresting and jailing drug addicts, and spend it instead on reconnecting them — to their own feelings, and to the wider society. The most crucial step is to get them secure housing, and subsidized jobs so they have a purpose in life, and something to get out of bed for….

The results of all this are now in. An independent study by the British Journal of Criminology found that since total decriminalization, addiction has fallen, and injecting drug use is down by 50 percent. I’ll repeat that: injecting drug use is down by 50 percent. Decriminalization has been such a manifest success that very few people in Portugal want to go back to the old system. The main campaigner against the decriminalization back in 2000 was Joao Figueira, the country’s top drug cop. He offered all the dire warnings that we would expect from the Daily Mail or Fox News. But when we sat together in Lisbon, he told me that everything he predicted had not come to pass — and he now hopes the whole world will follow Portugal’s example.

Map of World showing where prostitution is legal

While Utah can always do better with regards to both porn and prescription drug abuse (we’re doing fabulously on alcohol), I don’t think that things here are so dire to declare porn a public health crisis.  If the legislature were serious, Utah could at least offer better sex education in schools.  Some schools in Europe already discuss porn as part of sex education.  Denmark already has porn in the curriculum, and a Danish professor says discussion with teenagers about the industry would make them more critical consumers.  Rhiannon Lucy Cosslett writes an opinion piece in the UK’s Guardian newspaper that Sex education without porn is not sex education.

Utah has been noted to have high porn use, but is it really that bad?  This article puts Utah in perspective with the rest of the country.

Utah’s porn usage isn’t quite as overwhelming when compared to the majority of other states in the country. In 2015, the adult site PornHub recorded 16 visits per capita from Utah visitors, half of what Washington, D.C.’s rate. While Utah lawmakers reject LGBT-friendly laws, their citizens are hungry for lesbian pornography. It is the top search term in the state, but it’s also consistent with a majority of states in the country.

I watched a very interesting video on Netflix, The Big Picture, by National Geographic.  Episode 3 discusses sex throughout the world.  While they did state that Utah was the #1 consumer of “streaming porn” over the internet and they confirm the previous paragraph, it could be a lot worse.

When it comes to streaming porn, what is the most popular search term in the US? 

Lesbian, and ironically that is true even in conservative Utah.  The term “bondage” is most popular in West Virginia, (which is also popular in Montana, Wyoming, and Idaho, although Wyoming and Idaho have large Mormon populations.) While all types of porn viewing are bad, I’m glad that Utahns were watching lesbians rather than trying to learn ways to rape women via bondage methods.  Maybe you will feel differently.

Where’s biggest hotspot for cheating on your spouse? 

That would be the Muslim country of Turkey (58% have reported cheating on their spouse.)

Which country has the most sex per year according to condom maker Durex?

Despite all the complaints about sex on television, the United States is in the middle of the pack at 113 times per year.  It’s not romantic Italy (106 times-ranked 20th), or France (120-ranked 6th), but Greece where participants claim to have sex 138 times per year.  On the other end of the spectrum is Japan, dead last in number of sexual encounters at 45 per year.  No wonder their population is shrinking.

What can Utah be proud of?

Utah can be proud that it is among the lowest in providing pornstars to the porn industry.  Most come from California, Florida, Texas, and the Midwest.  Utah can also be proud to be among the fewest to read the sex novel “50 Shades of Gray.”  Apparently that is very popular in New England.  Utah’s also low in strip clubs per capita (Hurley, Wisconsin has 6 strip clubs, or 1 for every 260 residents.)  Las Vegas, Tampa Bay, and Portland were among the top cities with strip clubs.

Iceland has the highest number of number of children born to unwed mothers (66%), followed by Sweden (55%).  Iceland also has the most sex partners (13%), followed by Finland (12.4%.)

Nationwide, the average college student consumes 5 alcoholic drinks per week.  During spring break when they head to popular destinations in Florida or Las Vegas, it can be 18 drinks per DAY!  And while they’re drinking (83% are drinking more), there is 74% more sex, and 57% have sex with 2 or more partners.  60% know a friend who had unprotected sex during spring break.

But it’s not just Spring Breakers who are having more sex; Florida senior citizens are acting like spring breakers, and STI’s (sexually transmitted infections) are up 71%!  Just 5% of these senior citizens are taking advantage of Medicare free screening.  The host notes “Somebody needs to have THE TALK with grandma and grandpa.”  That sounds like a serious public health concern.

But let’s get back to the evidence for sex addiction.  Cambridge University did a study that many proponents of the sex addiction model promote.  This article states 3 main findings:

Compulsive porn users craved porn (greater wanting), but did not have higher sexual desire (liking) than controls. This finding aligns perfectly with the current model of addiction, and refutes the theory that “higher sexual desire” causes compulsive porn use. Drug addicts are thought to be driven to seek their drug because they want – rather than enjoy – it. This abnormal process is known as incentive motivation, which is a hallmark of addiction disorders.

The other major finding (not reported in the media) was that over 50% of subjects (average age: 25) had difficulty achieving erections with real partners, yet could achieve erections with porn….

Finally, researchers found that younger subjects had enhanced reward circuit activity when exposed to porn cues. Higher dopamine spikes and greater reward sensitivity are major factors in adolescents being more vulnerable to addiction and sexual conditioning.

The results of the two Cambridge studies (study1, study2) and the Max Planck study (Brain Structure and Functional Connectivity Associated With Pornography Consumption: The Brain on Porn (2014), provide very strong support for hypotheses put forth here on YBOP from its inception in 2011.

How do others look at this study?

Antonia Crane: What happens to our brains when we watch porn?

Nikky Prause: Well, it’s pretty clear it’s a reward.

You mean like a Snickers bar or a cigarette?

And like cheese. And like pictures of puppies.

So we are depressed puppies, not necessarily porn-addicted ones.

Not exactly. What I mean is that seeing images of puppies would do a similar thing to our brains. It’s hard to have that conversation because people do say, “But the brain lights up just like cocaine.” It does have lots of overlap with it, but so do images of chocolate and puppies—the type of chocolate (or puppy) you like the most…I wish people understood that all that’s doing is saying, “I like it.” It’s not saying “I’m addicted.”

Is porn addictive?

No.

Is sex addictive?

There is less evidence. I don’t think it is, but I am not as strong on my no.

But so many people suffer from sex and love addiction or porn addiction and say they can’t stop the behaviors.

A lot of people think that, but we don’t have evidence for it. That’s the thing, if you are a member of the public and you Google this stuff, there are all kinds of counselors that are certain it happens and they write about it like it is fact.

One person wrote

On a message board for exMormons, an anonymous poster explained his own history of being told he was a porn addict by his church. “Most Mormon ‘porn addicts’ are not addicted at all,” he writes. “The ‘addiction’ is due largely in [part] to the taboo nature of it.” He asserts that some simply have higher sex drives than others, but the church refers to them as addicts.

“I realized this was true when a therapist suggested I attend a non-[Mormon] sexaholics anonymous group,” he said explaining he had been to LDS ones before. “I realized that my ‘addiction’ of 1-7 times/week would get me laughed out of such a meeting.”

Some experts believe labeling people as porn addicts actually is a self-fulfilling prophecy, and makes the situation worse, not better.

In January 2015, Joshua Grubbs of Case Western, published powerful research showing that seeing oneself as a porn addict was predicted not by how much porn one views, but by the degree of religiosity and moral attitudes towards sex. Now, Grubbs has published explosive follow-up research, demonstrating that believing oneself is addicted to porn actually causes pain and psychological problems, in contrast to the idea that identifying as a porn addict is a part of a road to recovery.
…..
Analyses confirmed that the self-perception as a porn addict predicted distress one year later, where either porn use or personality characteristics did not. If someone believed they were a sex addict, this belief predicted downstream psychological suffering, no matter how much, or how little, porn they were actually using.

This means that the large-scale promotion of the concept of “porn addiction,” in the media, on the Internet, by self-proclaimed experts and by an industry that preys off of an unrecognized disorder, appear to actually be hurting people. By telling people that their use of porn constitutes a disease, they are promulgating suffering and anxiety, instilling into people that their use of pornography means there is something wrong with them, and that this use has potentially dire consequences.

The word iatrogenic describes illnesses or damages that are acquired as a result of treatment. If you go into a hospital for an appendectomy, and get a staph infection in the hospital, that’s iatrogenic harm. The porn addiction treatment model is iatrogenic, creating harm under the guise of providing treatment and support.
…
I’ve seen many vulnerable people call themselves a porn addict, with much shame and fear, despite using less porn than many other people. As with Grubbs’ research, I’ve found that this self-imposed label has much to do with moral values about sex and pornography, and often comes from an impoverished understanding of human sexuality. People walk into my office reporting this, and contact me online, after they’ve been shamed and labelled in online discussion groups. When one has little understanding that ALL people struggle at times with their sexual desires, it’s very easy to listen to moralizing proclaimers of doom, and declare one’s sexual desires to be abnormal and unhealthy.

The large industry of intertwined media, therapists, coaches and advocates who have obsessively and gleefully promoted the idea that porn is addictive, claim that they help people by providing an explanation and an intervention for the problems related to porn. In response to Grubbs’ findings, it’s now their obligation to demonstrate empirically that their label, their treatments and their theories are beneficial. Because right now, the evidence suggests that their treatment is hurting people.

The people who are making money and fame from the idea of porn addiction may claim that science hasn’t looked at their theories the right way – or looked at the right people. They may try to discredit the work done by Grubbs, and challenge his findings. These proponents of porn addiction treatment will have to produce real research that supports their actual work, rather than mere extrapolations from other findings. Until then, the model of porn addiction is an unethical, harmful treatment which exploits people, just like the hucksters who sold snake oil and things like radioactive materials as medicine were engaged in harmful, dangerous and illegal practice.

Finally, here’s one more study that uses an EEG to measure brain waves.

Sex addiction may not be a real disorder, according to a new UCLA study.

Researchers measured brain waves in self-reported sex addicts. The scans revealed that their brain’s responses when viewing sexual pictures were not indicative of an addiction.

….

People are diagnosed with a sexual addiction, or hypersexuality, when they exhibit sexual urges that feel out of control, engage frequently in sexual behavior, have suffered negative consequences because of their sexual behavior and they are unable to stop their behavior.

Prause said these criteria could also indicate high sexual desire, which is not necessarily a disorder.

…

Prause and her team looked at the brains of 52 people, 39 men and 13 women between the ages of 18 to 39. All of them reported problems with controlling their urge to view sexual images. They were asked to fill out four questionnaires that reviewed their sexual behaviors, desires and compulsions. They also were asked to discuss the potential cognitive and behavioral consequences of their sexual behavior. The responses were similar to people who were currently seeking help for sexual addiction.

Then, the subjects looked at different photographs while having an electroencephalography (EEG) scan taken. The EEG measured brain waves, specifically electrical activity in the brain when cells communicate with each other.

Photographs were picked by researchers to evoke pleasant or unpleasant feelings. They included images of dismembered bodies, people cooking, people skiing and sex. Some of the sexual images were romantic, while others showed explicit heterosexual intercourse.

The researchers looked at so-called “event-related potentials,” the brain wave changes caused by looking at the photographs. They specifically were interested in the P300 response, which was how the brain responds 300 milliseconds after exposure to the picture. The response at this moment in time — which has previously used in other addiction and impulsivity studies — is higher when the person is stimulated by something that’s new or interesting to them.

The researchers hypothesized that the more addicted to sex a person was based on the results from the questionnaires, the higher their P300 response would be. However, they discovered that the P300 responses were not correlated to the severity of the person’s sexual addiction. Instead, their brain response was linked to their self-reported levels of sexual desire.

“Brain response was only related to the measure of sexual desire. In other words, hypersexuality does not appear to explain brain responses to sexual images any more than just having a high libido,” she said.

Robert Weiss, a sex addiction clinician and author, told U.S. News that this study doesn’t mean sex addiction isn’t a real problem.

“You can’t define an addiction by what a person eats, what kind of alcohol they drink or whether they play blackjack or craps,” Weiss said. “We look at their life and determine if a substance or behavior is negatively affecting the quality of their life to the point where they need help.”

One website claims that porn kills love, but

North American neuroscientists Prause and Pfaus recently published a study in which pornography use was related to greater sexual desire for one’s partner, not to ED or lower desire.⁸ An ocean away, European researchers Landripet and Stulhofer found that neither frequency of porn viewing nor changes in the frequency of use were related to erectile problems.⁹ Both published in a high-prestige medical journal, these two studies refute claims that watching porn desensitizes erectile function, which supposedly leads to decreased desire and arousal for partner sex.

What about Abstinence “pledges”?  These may backfire and cause even more damage.

“…pledge breakers have higher risk of HPV and nonmarital pregnancy. As a set, the results are consistent with the argument that pledgers use condoms and contraceptives less consistently and highlight unintended consequences of abstinence promotion.”

What are your thoughts?  Do you think sex addiction is real?  Is the term of sex addiction a way of avoiding responsibility and free agency?  What is to be done with people who seem to exhibit compulsive behavior?  Is better sex education that includes discussion or porn use helpful?